After a median follow-up of 14.4 months, the men who had Xtandi along with ADT experienced an improved radiographic progression-free survival advantage over those who had only ADT, regardless of their prior treatment.
The trial found that 80% of men with metastatic hormone-sensitiveprostate cancer who received enzalutamide (Xtandi) along with standard-of-care treatment (ADT) were alive after three years, compared with just 72% of men who received other nonsteroidal antiandrogens along with standard ADT therapy.
Health Canada has recently approved an expanded use for enzalutamide (Xtandi) so that it can now be prescribed to treat men with non-metastatic castration-resistant prostate cancer (nmCRPC).
Why are Zytiga and Xtandi added to ADT and not substituted for ADT? Do I really need to continue ADT when I use Xtandi or Zytiga?
The European Medicines Agency (EMA) has recommended that the use of Xofigo (Radium-223) be restricted. The restrictions, because of safety and efficacy concerns in men with castrate resistant prostate cancer (mCRPC), include that Xofigo can be used only after two other treatments have been taken; when other therapies cannot be used and not in combination with other 2nd line hormone therapies.
Once a man is castrate resistant and moves on a second line hormone therapy drug like Zytiga or Xtandi (aka AR inhibitors) it is inevitable that the Zytiga or Xtandi will also become ineffective.
When this happens, the question that comes is what should be the next treatment? Generally, the options currently available are either to move to the drug not initially used ( Zytiga if Xtandi was first used or Xtandi if Zytiga was used) or instead to use taxane chemotherapy (Taxotere aka docetaxel).
Statins have been in the prostate cancer news feeds for a long time. They are believed to potentiate the effects of the anti-hormonal agents used to treat metastatic castration-resistant prostate cancer (mCRPC). Different stages of prostate cancer as well as different treatment exposures might change the efficacy of statins.
There is a sad truth about the current state of affairs for the treatment of non-metastatic castration-resistant prostate cancer. Our treatments can best be described as being antiquated.
You have become castrate resistant and already have taken Provenge. Now, what treatment should be next? Currently, the two best options are either Zytiga (abiraterone) or Xtandi (enzalutamide). Which should come first?
Bipolar Androgen Therapy (BAT) can be used to treat metastatic castrate resistant prostate cancer (mCRPC) and to reverse Xtandi treatment resistance.
Earlier studies of men with metastatic prostate cancer who took enzalutamide (Xtandi) indicated that there might be an increase in the risk having a seizure. Is this risk real? The UPWARD Study
One of the most puzzling questions faced by men with advanced prostate cancer has to do with deciding which drug to take first, Zytiga (abiraterone) or Xtandi (enzalutamide)?